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The study aimed to delve into the incidence and risk factors associated with myocarditis and pericarditis following SARS-COV-2-19 vaccination, addressing a notable gap in understanding the safety profile of vaccinations. Through meticulous data selection from the National Health Insurance System (NHIS) database of Korea, the researchers employed both a case-crossover study and a nested case-control design to analyze temporal patterns and risk factors related to carditis occurrences post-immunization. Key findings revealed a significant association between SARS-COV-2-19 vaccination and the occurrence of carditis, with a strong temporal correlation observed within 10 days post-vaccination. Noteworthy factors contributing to carditis risk included the duration between vaccination and carditis, specific comorbidities and medication use. The study concluded by recommending an extended post-vaccination surveillance duration of at least 10 days and underscored the importance of considering individual medical histories and concurrent medication use in assessing vaccine-induced carditis risk. This study might contribute to understanding vaccine safety profiles and emphasizes the significance of comprehensive post-vaccination monitoring protocols.
This paper critically investigates the photographic representation of the US military presence in 1960s-80s Korea by Kuwabara Shisei (1936-), one of the most eminent Japanese photojournalists who has worked in Korea since 1964. The paper specifically discusses a collection of images of the United States Forces Korea (USFK) in his 1986 photobook Kankoku gen'ei (Korea 1964-86) which features the most comprehensive work he produced in Korea. Through close visual analysis and examination of the pictorial narrative that Kuwabara presents throughout the collection of USFK images in the photobook, the paper explores how Kuwabara's images tap into the different kinds of Cold War imaginaries from the existing visual iteration of the USFK in more widely circulating mass media, novels, and movies in Korea at the time. In addition, it underscores USFK images of Kuwabara as his staunch statement against the global presence of the US military. Kuwabara crafts his argument with the hindsight of a Japanese veteran photojournalist who had gained keen insight into the global American military base network through his experiences in Japan, Vietnam, and Cambodia during the 1960s and 1970s. Overall, through close analysis of Kuwabara's photographs, the paper sheds light on the value of looking at photographic representations of the US military for building an understanding of cultural implication of the US military presence in Cold War Korea.
This case study provides a comprehensive analysis of the intricate political risks faced by TikTok, the Chinese social media giant, within the complex US political landscape. Beginning with an exploration of the security concerns articulated by the US government, the discussion centers on TikTok’s data collection practices and their perceived impact on US national security. The narrative unfolds by elucidating the multifaceted strategies employed by TikTok and its parent company, ByteDance, to address these challenges, including litigation, endeavors toward Americanization, and technological adaptations. It also examines the evolution in the US government’s stance as well as TikTok’s adaptive strategies aimed at sustaining and expanding its presence in the US market. The study depicts the responses of the Chinese government to US policies, unraveling the broader implications of these developments on the global political-economic landscape, exploring the dynamics involved in US-China relations, and providing a deeper understanding of the complexities inherent in such interactions. Finally, this case study invites readers to engage in contemplation on the broader themes of political risks faced by multinational corporations, the challenges inherent in navigating global legal frontiers, and the intricate nature of US-China relations.
Increasing evidence has established a strong association between social anxiety disorder and suicidal behaviours, including suicidal ideation and suicide attempts. However, the association between social anxiety disorder and suicide mortality remains unclear.
Methods
This study analysed data from 15,776 patients with social anxiety disorder, extracted from a nationwide Taiwanese cohort between 2003 and 2017. Two unexposed groups without social anxiety disorder, matched by birth year and sex in 1:4 and 1:10 ratios, respectively, were used for comparison. Suicide deaths during the same period were examined. Psychiatric comorbidities commonly associated with social anxiety disorder, including schizophrenia, bipolar disorder, major depression, alcohol use disorder (AUD), substance use disorder (SUD), obsessive-compulsive disorder, autism, and attention deficit hyperactivity disorder, were identified.
Results
Time-dependent Cox regression models, adjusted for demographic factors and psychiatric comorbidities, revealed that individuals with social anxiety disorder had an increased risk of suicide (hazard ratio: 3.49 in the 1:4 matched analysis and 2.84 in the 1:10 matched analysis) compared with those without the disorder. Comorbidities such as schizophrenia, bipolar disorder, major depression, AUD, and SUD further increased the risk of suicide in patients with social anxiety disorder.
Conclusion
Social anxiety disorder is an independent risk factor for suicide death. Additional psychiatric comorbidities, including schizophrenia, major affective disorders, and AUD, further increased social anxiety disorder-related suicide risk. Therefore, mental health officers and clinicians should develop targeted suicide prevention strategies for individuals with social anxiety disorder.
Panic disorder (PD) may increase the likelihood of suicidal ideation and behaviors because of psychiatric comorbidities such as major depressive disorder (MDD). However, research has yet to demonstrate a direct relationship between PD and suicide mortality.
Method
Using data from Taiwan’s National Health Insurance Research Database, we identified 171,737 individuals with PD and 686,948 age- and sex-matched individuals without PD during 2003–2017. We assessed the risk of suicide within the same period. Psychiatric comorbidities such as schizophrenia, bipolar disorder, MDD, obsessive-compulsive disorder (OCD), autism, alcohol use disorder (AUD), and substance use disorder (SUD) were also evaluated. Time-dependent Cox regression models were used to compare the risk of suicide in different groups after adjustment for demographic data and psychiatric comorbidities.
Results
Our Cox regression model revealed that PD was an independent risk factor for suicide (hazard ratio [HR] = 1.85, 95% confidence interval [CI] = 1.59–2.14), regardless of psychiatric comorbidities. Among all comorbidities, MDD with PD was associated with the highest risk of suicide (HR = 6.08, 95% CI = 5.48–6.74), followed by autism (HR = 4.52, 95% CI = 1.66–12.29), schizophrenia (HR = 3.34, 95% CI = 2.7–4.13), bipolar disorder (HR = 3.20, 95% CI = 2.71–3.79), AUD (HR = 2.99, 95% CI = 2.41–3.72), SUD (HR = 2.82, 95% CI = 2.28–3.47), and OCD (HR = 2.10, 95% CI = 1.64–2.67).
Discussion
PD is an independent risk factor for suicide. Psychiatric comorbidities (i.e. schizophrenia, bipolar disorder, MDD, OCD, AUD, SUD, and autism) with PD increase the risk of suicide.
This study aimed to develop and validate the modified irritant gas syndrome agent (IGSA) criteria, utilizing readily available triage information and epidemiologic data to efficiently segregate patients based on the severity of hydrofluoric acid (HFA) exposure.
Methods
A retrospective analysis of 160 patients exposed to HFA was performed to develop the criteria and assess the criteria’s efficacy, focusing on age, respiratory rate, and compliance with IGSA standards. The criteria’s validity was assessed by comparing clinical outcomes between patients meeting the modified IGSA (mIGSA) criteria and those who did not as external and internal.
Results
The mIGSA criteria (or AIR criteria) consisting of the 3 clusters of age greater than 49, IGSA criteria satisfied, and respiratory rate greater than 19 was developed. The area under curve of receiver operating characteristic curve for prediction of the risk of confirmed HFA injury according to AIR criteria was 0.8415 at the external validation.
Conclusions
The mIGSA criteria offer a significant improvement in the triage of HFA exposure incidents, facilitating rapid identification and prioritization of patients with potentially severe outcomes. Future research should aim to further validate these criteria across diverse emergency scenarios, reinforcing their utility in global health emergency preparedness.
Paranosema locustae is an environmentally friendly parasitic predator with promising applications in locust control. In this study, transcriptome sequencing was conducted on gonadal tissues of Locusta migratoria males and females infected and uninfected with P. locustae at different developmental stages. A total of 18,635 differentially expressed genes (DEGs) were identified in female ovary tissue transcriptomes, with the highest number of DEGs observed at 1 day post-eclosion (7141). In male testis tissue transcriptomes, a total of 32,954 DEGs were identified, with the highest number observed at 9 days post-eclosion (11,245). Venn analysis revealed 25 common DEGs among female groups and 205 common DEGs among male groups. Gene ontology and Kyoto Encyclopaedia of Genes and Genome analyses indicated that DEGs were mainly enriched in basic metabolism such as amino acid metabolism, carbohydrate metabolism, lipid metabolism, and immune response processes. Protein–protein interaction analysis results indicated that L. migratoria regulates the expression of immune- and reproductive-related genes to meet the body's demands in different developmental stages after P. locustae infection. Immune- and reproductive-related genes in L. migratoria gonadal tissue were screened based on database annotation information and relevant literature. Genes such as Tsf, Hex1, Apolp-III, Serpin, Defense, Hsp70, Hsp90, JHBP, JHE, JHEH1, JHAMT, and VgR play important roles in the balance between immune response and reproduction in gonadal tissues. For transcriptome validation, Tsf, Hex1, and ApoLp-III were selected and verified by quantitative real-time polymerase chain reaction (qRT-PCR). Correlation analysis revealed that the qRT-PCR expression patterns were consistent with the RNA-Seq results. These findings contribute to further understanding the interaction mechanisms between locusts and P. locustae.
In 10-minute speaking, N95 respirators significantly decreased SARS-CoV-2 emissions compared with no-mask wearing. However, SARS-CoV-2 was detected in the air even when wearing N95 and surgical masks in patients with high viral loads. Therefore, universal masking of infected and uninfected persons is important for preventing COVID-19 transmission via the air.
Research evidence has established an association of obsessive-compulsive disorder (OCD) with suicidal thoughts and suicide attempts. However, further investigation is required to determine whether individuals with OCD have higher risk of death by suicide compared with those without OCD.
Methods
Of the entire Taiwanese population, between 2003 and 2017, 56,977 individuals with OCD were identified; they were then matched at a 1:4 ratio with 227,908 non-OCD individuals on the basis of their birth year and sex. Suicide mortality was assessed between 2003 and 2017 for both groups. Time-dependent Cox regression models were used to investigate the difference in suicide risk between individuals with versus without OCD.
Results
After adjustment for major psychiatric comorbidities (i.e., schizophrenia, bipolar disorder and major depressive disorder), the OCD group had higher risk of suicide (hazard ratio: 1.97, 95% confidence interval: 1.57–2.48) during the follow-up compared with the comparison group. Furthermore, OCD severity, as indicated by psychiatric hospitalizations due to OCD, was positively correlated with suicide risk.
Conclusions
Regardless of the existence of major psychiatric comorbidities, OCD was found to be an independent risk factor for death by suicide. A suicide prevention program specific to individuals with OCD may be developed in clinical practice in the future.
MicroRNAs (miRNAs) are endogenous, non-coding RNAs, which are functional in a variety of biological processes through post-transcriptional regulation of gene expression. However, the role of miRNAs in the interaction between Bacillus thuringiensis and insects remains unclear. In this study, small RNA libraries were constructed for B. thuringiensis-infected (Bt) and uninfected (CK) Spodoptera exigua larvae (treated with double-distilled water) using Illumina sequencing. Utilising the miRDeep2 and Randfold, a total of 233 known and 726 novel miRNAs were identified, among which 16 up-regulated and 34 down-regulated differentially expressed (DE) miRNAs were identified compared to the CK. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that potential target genes of DE miRNAs were associated with ABC transporters, fatty acid metabolism and MAPK signalling pathway which are related to the development, reproduction and immunity. Moreover, two miRNA core genes, SeDicer1 and SeAgo1 were identified. The phylogenetic tree showed that lepidopteran Dicer1 clustered into one branch, with SeDicer1 in the position closest to Spodoptera litura Dicer1. A similar phylogenetic relationship was observed in the Ago1 protein. Expression of SeDicer1 increased at 72 h post infection (hpi) with B. thuringiensis; however, expression of SeDicer1 and SeAgo1 decreased at 96 hpi. The RNAi results showed that the knockdown of SeDicer1 directly caused the down-regulation of miRNAs and promoted the mortality of S. exigua infected by B. thuringiensis GS57. In conclusion, our study is crucial to understand the relationship between miRNAs and various biological processes caused by B. thuringiensis infection, and develop an integrated pest management strategy for S. exigua via miRNAs.
Despite its transformative impact, a systematic approach to Smart PSS development remains elusive. Addressing this, the study introduces a dynamic conceptual model named DHSmart and its accompanying canvas, adaptable to various contexts and technological advancements. Notably, it offers a structured approach to designing ‘Smart’ in Smart PSS, capturing the interplay between data, humans, and smart systems while directing digitalisation that achieves competitive advantage. It also serves as a unifying framework, enabling meaningful interdisciplinary contributions in theory and practice.
This study aimed to assess the actual burden of antibiotic use among end-of-life (EOL) patients in South Korea and to compare trends between cancer and non-cancer decedents.
Design:
Population-based mortality follow-back study.
Setting:
Data from the Korean National Health Insurance Database, covering the period from January1, 2006, to December 31, 2018, provided for research by the National Health Insurance Service (NHIS), were used.
Participants:
All decedents from 2006 to 2018 were included and categorized as cancer decedents or non-cancer decedents.
Methods:
Annual antibiotic consumption rates and prescription rates were calculated, and Poisson regression was used to estimate their trends.
Results:
Overall antibiotic consumption rates decreased slightly among decedents in their final month with a less pronounced annual decrease rate among cancer decedents compared to non-cancer decedents (0.4% vs 2.3% per year, P <.001). Over the study period, although narrow spectrum antibiotics were used less, utilization and prescription of broad-spectrum antibiotics steadily increased, and prescription rates were higher in cancer decedents compared to non-cancer controls. Specifically, carbapenem prescription rates increased from 5.6% to 18.5%, (RR 1.087, 95% CI 1.085–1.088, P <.001) in cancer decedents and from 2.9% to 13.2% (RR 1.115, 95% CI 1.113–1.116, P <.001) in non-cancer decedents.
Conclusions:
Our findings show that patients at the EOL, especially those with cancer, are increasingly and highly exposed to broad-spectrum antibiotics. Measures of antibiotic stewardship are required among this population.
Artificial intelligence and cognitive science are two core research areas in design. Artificial intelligence shows the capability of analysing massive amounts of data which supports making predictions, uncovering patterns and generating insights in varying design activities, while cognitive science provides the advantage of revealing the inherent mental processes and mechanisms of humans in design. Both artificial intelligence and cognitive science in design research are focused on delivering more innovative and efficient design outcomes and processes. Therefore, this thematic collection on “Applications of Artificial Intelligence and Cognitive Science in Design” brings together state-of-the-art research in artificial intelligence and cognitive science to showcase the emerging trend of applying artificial intelligence techniques and neurophysiological and biometric measures in design research. Three promising future research directions: 1) human-in-the-loop AI for design, 2) multimodal measures for design, and 3) AI for design cognitive data analysis and interpretation, are suggested by analysing the research papers collected. A framework for integration of artificial intelligence and cognitive science in design, incorporating the three research directions, is proposed to inspire and guide design researchers in exploring human-centred design methods, strategies, solutions, tools and systems.
Todorokite is a common Mn oxide (with a tunnel structure) in the Earth surface environment, and can be obtained by hydrothermal treatment or refluxing process from precursor buserite with a layered structure. Several chemical reaction conditions for the phase transformation from Na-buserite to todorokite at atmospheric pressure were investigated, including temperature, pH, crystallinity of precursor Na-buserite, the amount of the interlayer Mg2+ of the Mg-buserite and clay minerals. The results showed that the conversion rate and crystallinity of todorokite decreased with falling temperature, and Mg-buserite could not be completely transformed to todorokite at lower temperatures (40°C). The poorly crystalline Na-buserite could be converted into todorokite more easily than highly crystalline Na-buserite. Todorokite can be prepared at pH 5–9, but the rate of conversion and crystallinity of todorokite did vary with pH in the order: neutral ≈ alkali > acidic. The conversion rate of todorokite decreased with decreasing interlayer Mg2+ content of the Mg-buserite. The presence of montmorillonite or goethite slowed the formation reaction of todorokite in the refluxing process, and the reaction time was prolonged when the amounts of those minerals were increased.
The “Fast track” protocol is an early extubation strategy to reduce ventilator-associated complications and induce early recovery after open-heart surgery. This study compared clinical outcomes between operating room extubation and ICU extubation after open-heart surgery in patients with CHD.
Methods:
We retrospectively reviewed 215 patients who underwent open-heart surgery for CHDs under the scheduled “Fast track” protocol between September 2016 and April 2022. The clinical endpoints were post-operative complications, including bleeding, respiratory and neurological complications, and hospital/ICU stays.
Results:
The patients were divided into operating room extubation (group O, n = 124) and ICU extubation (group I, n=91) groups. The most frequently performed procedures were patch closures of the atrial septal (107/215, 49.8%) and ventricular septal (89/215, 41.4%) defects. There were no significant differences in major post-operative complications or ICU and hospital stay duration between the two groups; however, patients in group I showed longer mechanical ventilatory support (0.0 min vs. 59.0 min (interquartile range: 17.0–169.0), p < 0.001). Patients in Group O showed higher initial lactate levels (3.2 ± 1.7 mg/dL versus 2.5 ± 2.0 mg/dL, p = 0.007) and more frequently used additional sedatives and opioid analgesics (33.1% versus 19.8%, p = 0.031).
Conclusions:
Extubation in the operating room was not beneficial for patients during post-operative ICU or hospital stay. Early extubation in the ICU resulted in more stable hemodynamics in the immediate post-operative period and required less use of sedatives and analgesics.
Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear.
Aims
To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders.
Method
Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders.
Results
A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02–5.29) or accident (RR = 1.62, 95% CI 1.43–1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40–1.66), bipolar disorder (RR = 1.99, 95% CI 1.83–2.16), MDD (RR = 1.98, 95% CI 1.89–2.08) or ADHD (RR = 1.34, 95% CI 1.24–1.44).
Conclusions
Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.
The early-stage engineering design activities include conceptualising, identifying, and solving an engineering design problem. These activities are essential and standard roles of a design engineer. However, they seem to lack comprehensive practice within the engineering design community. In this study, semi-structured interviews conducted with 18 participants having engineering design backgrounds are presented. The aim of the interviews is to investigate the awareness and practice of the early stage engineering design activities. The participants interviewed practice in countries including France, the United Kingdom, and the United States. Contrary to standard expectations, the results of the interviews show that the early-stage engineering design activities are not comprehensively practised. The results suggest that design engineers' crucial role in identifying unknown problems lacks practice. Also, the data from the interviews provide empirical evidence on the determinants for the lack of comprehensive practice of early-stage engineering design activities. Recommendations on possible interventions to support the practice are presented to expedite innovations and inventions.
The availability of digital data in the fourth industrial revolution brings different trends with new opportunities and challenges for the engineering design community. As an opportunity, these trends would impact engineering design. However, the challenge is finding applications for these trends in engineering design. Crowdsourcing is one of the trends inspired by digital data. It is outsourcing an individually performed task to be mass-performed. This paper explores the application of crowdsourcing in identifying engineering design problems. Identifying an engineering design problem is an aspect of engineering design considered challenging but necessary for inventions. Secondary data from 63 invention-related cases and an interview with a renowned UK inventor are presented. The data contains scenarios on how the engineering design problems solved to qualify for a UK patent grant or application are identified. Lessons from the case studies are presented and discussed, especially regarding crowdsourcing engineering design problems. These seem to be promising ways of supporting the identification of new engineering design problems with inventive benefits once solved.
Crowdfunding is becoming increasingly popular for funding projects, particularly in the domain of product design, by asking a large group of people. Previous studies have indicated that creativity plays a significant role in product design and is considered an important factor of success for new product design and development. However, these studies have not explicitly explored the role of creativity in crowdfunding product design projects. This paper investigates this issue by conducting a case study employing expert evaluations of selected successful and unsuccessful crowdfunding product design project samples. The results of the study show there is a positive relationship between the creativity of a product and the success of its crowdfunding campaign. Therefore, creativity can be considered a success factor of crowdfunding. The study also suggests creative products, especially useful ones, might have more potential to attract people's willingness to fund them. This paper has contributed to the research on design, creativity, product design and development, and funding business models. Most importantly, this paper has raised the significance of creativity in design and business.
The ideation process has a significant impact on the initial concept generation and final product creativity of the design. Visual stimuli play an important role in the process of innovative product design. With the increase in computing capability, generative design methods are widely implemented. In this paper, features of design targets and combinational objects in 2 combinational design tasks are fused using adversarial neural generative networks to form the generated stimuli. It is also used with combinational object pictures to investigate the impact on creativity in design ideation. The study invited designers to use and subjectively self-evaluate the two stimuli in a design task. Through analysis of participant data (n=20), the results showed that the generative stimuli had an advantage over the combinational image stimuli in terms of the smoothness of creativity in the design ideation of outcomes. And there is a positive correlation between designers' years of design education and their tendency to prefer generative stimuli. Based on the results obtained, ideas are provided for the study of the influence of visual and generative stimuli on the designer's ideation process.